Indicator 16.6.2 Proportion of population satisfied with their last experience of public services

Goal 16: Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels.

Target 16.6: Develop effective, accountable and transparent institutions at all levels.

16.6.2. Proportion of population satisfied with their last experience of public services

November 2021

Indicator 1.1.4, 3.8.1, 3.7.1

Uganda Bureau of Statistics

Junda Nuwamanya

Demography and Social Statistics

Senior Statistician Crime Statistics

+256 782 602544

P.O Box 7186, Kampala

junda.nuwamanya@ubos.org

Definition

This indicator measures levels of public satisfaction with people’s last experience with public services, in the three service areas of healthcare, education and government services (i.e. services to obtain government-issued identification documents and services for the civil registration of life events such as births, marriages and deaths). This is a survey-based indicator which emphasizes citizens’ experiences over general perceptions, with an eye on measuring the availability and quality of services as they were actually delivered to survey respondents.

Concepts:

Public services: As stated by the United Nations High Commissioner for Human Rights, “States are responsible for delivering a variety of services to their populations, including education, health and social welfare services. The provision of these services is essential to the protection of human rights such as the right to housing, health, education and food. The role of the public sector as service provider or regulator of the private provision of services is crucial for the realization of all human rights, particularly social and economic rights.

” Public services ‘of general interest’: The methodology for SDG 16.6.2 carefully defines the scope of healthcare and education services to ensure that the focus is placed on services that are truly of general interest. In the case of healthcare services, for instance, preventive and primary healthcare services can be said to be truly ‘of general interest’: these services are relevant to everyone and they are most commonly found in both urban and rural areas. This might not be the case for hospitals that provide tertiary care, and as such hospital and specialist care is excluded from the questions on healthcare services. Likewise, in the case of education services, primary and lower secondary education services can be said to be truly ‘of general interest’, given their universality. University education, however, is excluded from the questions on education services.

‘Last experience’ of public services in the past 12 months: Indicator 16.6.2 focuses on respondents’ ‘last experience of public services’, and specifies a reference period of “the past 12 months” to avoid telescoping effects and to minimize memory bias effects. This means that only respondents who will have used healthcare, education and government services in the past 12 months will proceed to answer the survey questions.

Service-specific standards – or ‘attributes’: The United Nations High Commissioner for Human Rights explains that “A human rights-based approach to public services is integral to the design, delivery, implementation and monitoring of all public service provision. Firstly, the normative human rights framework provides an important legal yardstick for measuring how well public service is designed and delivered and whether the benefits reach rights-holders”. For instance, the Committee on Economic, Social and Cultural Rights specifies that “The availability, accessibility, acceptability and quality of health-related services should be facilitated and controlled by States. This duty extends to a variety of health-related services ranging from controlling the spread of infectious diseases to ensuring maternal health and adequate facilities for children.” Similarly, with respect to education services, the same Committee underlines that “States should adopt a human rights approach to ensure that [education services are] of an adequate standard and do not exclude any child on the basis of race, religion, geographical location or any other defining characteristic.”

Healthcare services: The questions on healthcare services focus on respondents’ experiences (or that of a child in their household who needed treatment and was accompanied by the respondent) with primary healthcare services (over the past 12 months) – that is, basic health care services provided by a government/public health clinic, or covered by a public health system. It can include health care services provided by private institutions, as long as such services are provided at reduced (or no) cost to beneficiaries, under a public health system. Respondents are specifically asked not to include in their answers any experience they might have had with hospital or specialist medical care services (for example, if they had a surgery), or with dental care and teeth exams (because in many countries, dental care is not covered by publicly funded healthcare systems). Attributes-based questions on healthcare services focus on 1) Accessibility (related to geographic proximity, delay in getting appointment, waiting time to see doctor on day of appointment); 2) Affordability; 3) Quality of facilities; 4) Equal treatment for everyone; and 5) Courtesy and treatment (attitude of healthcare staff).

Education services: The questions on education services focuses on respondents’ experience with the public school system over the past 12 months, that is, if there are children in their household whose age falls within the age range spanning primary and secondary education in the country. Public schools are defined as “those for which no private tuition fees or major payments must be paid by the parent or guardian of the child who is attending the school; they are state-funded schools.” Respondents are asked to respond separately for primary and secondary schools if children in their household attend school at different levels. Attributes-based questions on education services focus on 1) Accessibility (with a focus on geographic proximity); 2) Affordability; 3) Quality of facilities; 4) Equal treatment for everyone; and 5) Effective delivery of service (Quality of teaching).

Government services: The battery on government services focuses exclusively on two types of government services: 1) Services to obtain government-issued identification documents (such as national identity cards, passports, driver’s licenses and voter’s cards) and 2) services for the civil registration of life events such as births, marriages and deaths. This particular focus on these two types of services arises from the high frequency of use of these services. Attributes-based questions on government services focus on 1) Accessibility; 2) Affordability; 3) Equal treatment for everyone; 4) Effective delivery of service (delivery process is simple and easy to understand); and 5) Timeliness.

Proportion

None

This indicator is generated from the National Governance Peace and Security Survey 2017

The NGPSS 2017 underwent several stages of implementation which included: survey organization, Stakeholder consultative meetings where user needs were identified, sample selection, questionnaire and application development, pretesting and finalization of questionnaires, recruitment and training of field staff, field data collection and capture, data processing, management, cleaning and analysis; report writing and production. At each stage, the survey conformed to international best practices in survey implementation. In addition, all relevant international standards were followed during the generation of the indicator.

Sample Design:

The sample was designed to allow generation of separate estimates at the national level, residence and for the 5 Statistical Regions of Uganda. A three stage cluster sampling design was employed to select a representative sample at household level. At the first stage, EAs were grouped by districts of similar socio-economic characteristics and by rural-urban location. The EAs were then drawn using Probability Proportional to Size. At the second stage, households which are the ultimate sampling units were drawn using Systematic Random Sampling. A total of 300 Enumeration Areas were selected from the 2014 National Population and Housing Census (NPHC) list which constituted the Sampling Frame.

Training and field work:

A team of field supervisors and interviewers were recruited and trained for the main survey. The training lasted ten days and the main approach of training comprised of classroom instructions on interviewing techniques, field procedures, a detailed review of the data collection tool, tests and practice using hand-held Computer Assisted Personal Interviews (CAPI) devices. The training also included classroom mock interviews and field practice in selected EAs outside of the main sample. Team supervisors were further trained in data quality control procedures and coordination of fieldwork activities.

Data collection:

The interview method of data collection was employed where interviewers asked the selected respondent in the household to provide the applicable response. During data collection, the interviewers asked respondents the question; How well do you think your local authority is handling the following:

A = Reporting back to the people

B = Consulting traditional / community leaders

C = Delivering local services 1. Very badly 2. Badly 3. Well 4. Very well

The survey is expected every 5 years

2023

Uganda Bureau of Statistics

Department of Demography and Social Statistics

The Uganda Bureau of Statistics (UBOS) Act, 1998 provides for the development and maintenance of a National Statistical System (NSS) to ensure collection, analysis and publication of integrated, relevant, reliable and timely statistical information. It established the Bureau as the coordinating, monitoring and supervisory body for the National Statistical System.

Government of Uganda has an obligation to provide a wide range of public services that should meet the expectations of their citizens in terms of access, responsiveness and reliability/quality. When citizens cannot afford some essential services, when their geographic or electronic access to services and information is difficult, when the services provided do not respond to their needs and are of poor quality, citizens will naturally tend to report lower satisfaction not only with these services, but also with public institutions and governments. In this regard, it has been shown that citizens’ experience with front-line public services affects their trust in public institutions. Mindful of this close connection between service provision/performance, citizen satisfaction and public trust, governments are increasingly interested in better understanding citizens’ needs, experiences and preferences to be able to provide better targeted services, including for underserved populations.

Measuring satisfaction with public services is at the heart of a citizen-centered approach to service delivery and an important outcome indicator of overall government performance. Yet while a large number of countries have experience with measuring citizen satisfaction with public services, there is also large variability in the ways national statistical offices and government agencies in individual countries collect data in this area, in terms of the range of services included, the specific attributes of services examined, question wording and response formats, among other methodological considerations. This variability poses a significant challenge for cross-country comparison of such data.

SDG indicator 16.6.2 aims to generate globally comparable data on satisfaction with public services. To this end, SDG 16.6.2 focuses global reporting on the three service areas of (1) healthcare, (2) education and (3) government services (i.e. services to obtain government-issued identification documents and services for the civil registration of life events such as births, marriages and deaths).

The rationale for selecting these three public services is threefold:

• First, these are ‘services of consequence’, salient for all countries and for both rural and urban populations within countries. They are also among the most common service areas covered by national household or citizen surveys on satisfaction with public services.
• Second, while healthcare and education services are covered by other SDG indicators, most of these other indicators rely on administrative sources (i.e. they do not measure people’s direct experiences and level of satisfaction with services) and are mainly focused on measuring the national coverage of a given service.
• Third, government services are not monitored under other Goals. This is a gap that indicator 16.6.2 can usefully f ill, especially since Goal 16 is dedicated to enhancing governance. While Goal 16 does consider birth registration services under indicator 16.9.1, it falls short of measuring satisfaction with the services provided.

With the aim of generating harmonized statistics, indicator 16.6.2 is measured through five attributes-based questions under each service area (e.g. on the accessibility and affordability of the service, the quality of facilities, etc.):

The attributes-based questions are asked before the overall satisfaction question. This is based on the intention to enhance the accuracy of the proposed statistical measure on overall satisfaction – that is, to ensure that it correctly reflects the underlying concept that it is intended to capture (based on the specific attributes selected for each service). Experts in governance measurements have found that citizen satisfaction with public services is influenced not only by citizens’ previous experiences with the services, but also by citizens’ expectations. These can be influenced by cultural assumptions about the extent to which service providers should be responsive to citizens’ preferences; by broad public perception of services as communicated through the media; by individual experiences of friends, family and acquaintances; and by how service providers themselves communicate about the type of services they commit to delivering. For instance, national experiences with different question formats have shown that more highly educated respondents who interact more frequently with government (and who possibly have higher awareness of their own rights and of their government’s obligations) have higher expectations in terms of what constitutes a public service of ‘good quality’, compared to the rest of the population

The way the question was asked needed more probing in a qualitative module given the subjectivity of the question. However, this was not covered by the survey.

The question used for data collection was: How well do you think your local authority is handling the following:

A=Reporting back to the people

B=Consulting traditional / community leaders

C=Delivering local services

1. Very badly 2. Badly 3. Well 4. very well

The responses for delivering local services were used as a proxy for service delivery within that community. Codes 3 and 4 were computed expressed as a percentage of all the respondents.

A validation Technical working meeting was held for selected stakeholders before the dissemination of the NGPSS 2017 Report.

The Paria Group developed a Governance Handbook to guide all countries in the development of Governance Statistics at national level.

To ensure quality management of the survey results; the survey implementation underwent a series of checks by the UBOS management.

The survey implementation was over seen by a Core team consisting of staff from both UBOS and Makerere University School of Statistics and Planning right from the inception to its finalization.

The survey report was reviewed by UBOS management who are Directors.

The NGPSS 2017 underwent several stages before production and sharing of the final findings.  The Survey implementation covered these aspects to address quality assurance;

1. Consultative user needs assessment meetings are held with all key stakeholders.
2. The survey and sampling design generated using scientific methods as recommended by the Census and Survey Rules and Regulations.
3. The questionnaire development follows a multi-stakeholder approach and pretesting helps to establish the relevancy and adequacy of the questions to be used
4. Senior Supervision is conducted during data collection to ensure that quality data is collected
5. Data editing, cleaning and coding is undertaken before analysis and report writing.

Before dissemination, the report is reviewed and quality assured by the Department of Outreach and Quality Assurance at the Bureau.

National, Sex, Region and Residence

None

The National Governance Peace and Security Survey report 2017 by UBOS www.ubospublications.org.ug